Hair Loss in Menopause and PCOS ( Polycystic Ovary Syndrome )

Hair loss is a troubling concern that can instigate agonizing moments in any woman’s life at various points. Hair loss may be a standard part of the ageing process in men, but hormonal imbalances (especially those that occur due to menopause and for women with Polycystic Ovary Syndrome (PCOS)) can also cause hair loss.

How Hormones Determine Hair Growth and Loss

 The production of hormones in the body profoundly influences the speed at which hair grows. The hair-growth cycle is broken down into three stages: anagen (growth), catagen (transitional) and telogen (resting). Testosterone and its more potent derivative, dihydrotestosterone (DHT), are male hormones called Androgens that profoundly affect this cycle. While these hormones promote hair growth in specific body parts, they can also lead to hair thinning and loss when found in more significant amounts, especially on the scalp. Both estrogen — the female hormone that helps maintain hair density and growth — and male hormones produce more hairs in their growth phase, so as estrogen drops to almost nothing in menopause or in women with PCOS, hair starts falling out.

Hair Loss During Menopause

Menopause is an important period in every woman’s life because it occurs between the ages of 45 and 55. When women reach menopause, a decline in estrogen and progesterone results in the scales tilting towards an increased presence of androgens, which inhibit hair follicles. One noticeable change is androgenetic alopecia (AGA), or male-patterned hair loss, which typically starts at the crown and extends along the part line.

 

What Are The Symptoms Of Menopausal Hair Loss?

Thinning hair (usually at the crown of the head)

Widening of the part line

Hair falls off when you shampoo or comb your hair.

More breaking and brittle strands

PCOS (Polycystic Ovary Syndrome) and Hair Loss

Polycystic Ovary Syndrome (PCOS) is a hormonal issue that affects 10% of women in their reproductive years. PCOS causes elevated androgen levels, most significantly testosterone and DHT, which results in a number of symptoms, including hair loss. With PCOS, hair loss more often conforms to the ‘Christmas Tree Pattern’, where thinning starts at the centre of the scalp and moves frontward.

Genetic cause of hair loss and PCOS

The testosterone produced, instead of being used quickly, can then be converted to DHT. This DHT attaches itself to hair follicles and slowly makes them shrink off, which is why women with PCOS usually produce thinner, weaker hair. This condition, called androgenetic alopecia, also leads to hair loss in women with PCOS. It turns out that it has a genetic predisposition as well.

But paradoxically, while testosterone and DHT are capable of thinning the hair on the scalp, they can promote overgrowth of hair in different locations in both men and women – a phenomenon called hirsutism. This contradiction, where some areas of hair grow without desire while the scalp area becomes thinner, is a symptom unique to PCOS.

Although it is still true that high levels of androgens are a common cause of hair loss in women with PCOS, not all women with PCOS have abnormal testosterone or DHT measured in their blood. Most of these hormones are synthesized in the skin, fat and breast tissue, often not correlated with blood levels and thus act locally, but they also act systemically via this mechanism. The diagnosis and treatment of PCOS-related hair loss can be difficult as a result.

PCOS Hair Loss Symptoms

Hair loss at the top of their head and receding hairline

Widening part line

Excessive hair shedding

Apart from those, it manages to treat other symptoms of Androgen excess like acne, hirsutism and irregular periods.

A contributing factor is insulin resistance. Insulin resistance is a major feature of PCOS and predisposes women to developing male-pattern hair loss. Higher levels of insulin trigger the ovaries to produce more male hormones (androgens), which may cause hair loss. So, losing weight to fight insulin resistance will give you another leverage to get your hair back.

Menopause and PCOS Hair Loss Treatments

Hair loss in women with menopause or PCOS is often multifactorial and requires medical, lifestyle and occasionally surgical intervention. Knowing the options better:

  • Minoxidil (Rogaine)

Minoxidil is a topical treatment for female pattern hair loss recommended by the FDA. It works by activating the hair follicles and lengthening the growth phase. Minoxidil is helpful for both menopausal and PCOS-related hair loss; however, it will take a few months to start working, and you have to continue to use it indefinitely.

  • Hormone Replacement Therapy (HRT) — The use of medication containing estrogen and/or progestin to replace natural hormones, typically used by women in perimenopause or menopause.

Hormone replacement therapy (HRT) may also be useful for menopausal women, as it could improve the balance of estrogen and androgens, slowing down hair loss. However, the extent to which HRT can reverse hair loss, along with all of its associated risks and benefits, is not known.

  • Anti-Androgen Medications

Blocking the effects of testosterone and DHT on hair follicles is effective in reducing hair loss for women with PCOS, in that spices and pills are helpful as anti-androgen prescribed drugs. It is not recommended for use in pregnancy and is prescribed by doctor, Spironolactone

  • Finasteride

Finasteride is an additional anti-androgen treatment and also works by blocking the enzyme 5-alpha-reductase, which converts testosterone to DHT. Finasteride lowers DHT, so when you take it, the damage to your hair follicles is no longer being done, and in many cases, finasteride can even cause complete regrowth. While it is primarily used by men, finasteride can be prescribed to women who have androgenetic alopecia, although more commonly in women with PCOS-associated hair loss.

In a study evaluating dark-skinned individuals, finasteride was found to significantly increase hair density and thickness. It can also help decrease unwanted hair growth in women with hirsutism.

  • Lifestyle Changes

Well, due to insulin resistance, all women with PCOS develop at some level; by fixing this issue via diet/supplements/behaviour changes, you may prevent hair loss and improve health. When you lose weight through diet and exercise, there will be a decrease in the amount of androgens that can lower hair shredding. Again, an endocrinologist must be involved with a dietitian since it is crucial to develop a plan that allows weight loss (if the latter suggests this) and keeps hormones balanced.

  • Hair Transplantation

In the case of extended hair loss with age (menopause and PCOS) or scarring alopecias, the only option left is surgery for a hair transplant. During a hair transplant procedure, follicles from areas that are less sensitive to DHT (for example, the back of the scalp) are taken and put in locations where DHT has caused thinning. This is done by implanting the hair individually with a FUE (Follicular Unit Extraction) technique that causes minimal scarring.

While hair loss from menopause and PCOS are medically benign, they can be very emotionally distressing for women. The changes in their physical appearance make many women feel not very feminine; they even have low self-esteem and are isolated from society. Help for the emotional side of hair loss · Counseling, support groups, and even talking to your friends or loved ones can help women cope with the stress related to their hair loss.

Hair loss in women, whether by menopause or PCOS, is a very intimate thing and one that causes distress. Thinning hair is the result of hormonal imbalance in both cases, with PCOS also causing excess body hair growth. Treatment options include topical medications like Minoxidil and anti-androgen medications such as Spironolactone and finasteride, lifestyle change or hair transplantation.

If you have hair loss due to menopause or PCOS, see your healthcare professional to be evaluated for treatment opportunities. Otherwise, take the situation into your own hands and consult with a physician to find the best possible treatment for hair loss.GetResponse.

At Smile Hair Clinic, specialists offer women individually tailored hair transplantation options that respect female hairlines and scalp anatomy. It enables the transplanted hair to look natural and integrate well with the original.

 

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